Tripathi Shweta Sharma Deepika Paliwal Poonam Thakur Anurag Mehta Dinesh Doval Dual Primary Malignancy A Primary Cause of Concern CANCER STATISTICS WORLD Globocan 2018 ID: 919443
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Slide1
Swarnima Jaitley
, Rupal Tripathi; Shweta Sharma; Deepika Paliwal; Poonam Thakur; Anurag Mehta; Dinesh Doval
Dual Primary Malignancy: A Primary
Cause
of
Concern
Slide2CANCER
STATISTICS- WORLDGlobocan- 2018
Cancer is the second leading cause of death
globally
An
estimated 9.6 million deaths in 2018. Globally,
Approximately 70% of deaths from cancer occur in low- and middle-income countries.
Around one third of deaths from cancer are due to the 5 leading behavioral and dietary risks: high body mass index, low fruit and vegetable intake, lack of physical activity, tobacco use, and alcohol use.
Tobacco use is the most important risk factor and is responsible for approximately 22% of cancer
deaths.
Cancer causing infections, such as hepatitis and human papilloma virus (HPV), are responsible for up to 25% of cancer cases in low- and middle-income countries
The economic impact of cancer is significant and is increasing. The total annual economic cost of cancer in 2010 was estimated at approximately US$ 1.16 trillion
Only 1 in 5 low- and middle-income countries have the necessary data to drive cancer policy
Slide3Total population 7632819272
Number of new cases 18078957
Number of deaths 9555027
Number of prevalent cases (5-year)
43841302
Globocan
- 2018
Slide4Slide55,000 year old civilization
419 Languages spoken23 official languages
29 states, 7 union territories
Area – 3.28 million sq. kilometers
7
th
Largest country in the world
2
nd most populous country in the world
Coastline- 7517 kilometers133.92
crores people in 2017
Slide6Total population:
1354051855
Number of new cases: 1157294
Number
of
deaths:
784821
Number of prevalent cases (5-year
): 2258208
Globocan
2018
Slide7CANCER
STATISTICS- INDIAGlobocan- 2018
The
five most frequent cancers
in
India between men and women are
breast, cervical, oral cavity, lung, and colorectal.
These top five account for 47.2 per cent of all
cancersCancer is the second most common cause of death
in India (after cardiovascular disease).4. As
many as 2,500 persons die every day due to tobacco -related diseases in India.5. More women in India die from cervical cancer than in any other country. Rural women are at higher risk of developing cervical cancer as compared to their urban counterparts.6. Breast
cancer is the most common cancer in women in India and accounts for about a quarter of all cancers in women in Indian cities
7. The
average age for breast cancer in India is almost a decade lower than that in the west.
8. Cancers
of major public health relevance such as breast, oral, cervical, gastric, lung, and colorectal cancer
can be cured if detected early and treated adequately.
One woman dies of cervical cancer every 8 minutes in India
Slide8CANCER
STATSTICTS- INDIA
Geographic distribution and burden of cancers in India. (Image: cancerindia.org)
Slide9Slide10PROFILE OF THE INSTITUTE
Owned by the
Indraprastha
Cancer Society and Research Centre.
Run on : “No Profit No Loss Basis”.
Managed by a Governing Council appointed by
Indraprastha
Cancer Society and Research Centre
Hospital started in July 1996
as a 152 Bedded Hospital
Total area of the hospital 5 acres.
Presently 498 Bedded NABH Accredited Hospital
Aims to Provide the Best Oncology Care
Registered almost 2.6
lacs
patients in last 23
yrs
Slide11To
prevent and treat
cancer by providing
affordable
oncology care of international standards in India
To be the largest cancer care provider in India by
2020
Based on core values of quality, ethics, compassion and respect for all
Offering comprehensive services from
prevention to palliation
at an affordable price
VISION
MISSION
MISSION
MISSION
Slide12SOME FACTS…
Slide13Slide14ACADEMIC PROGRAMS
Post Graduate Program, DNB (Diploma of National Board) in Radiotherapy, Radiology, Anesthesiology, Surgical Oncology and Medical Oncology
2 year Fellowship Program in Pediatric
Hemato
Oncology
B
Sc
Medical Technology (Radiotherapy)
Diploma in
X-Ray & Imaging Technology (DXIT)
Operation Theatre Technology (DOT)Medical Laboratory Technology (DMLT)Medical Records Technology (DMRT)
One year on job training course in “MRI in Oncology” exclusively at RGCIRC
Fellowship in Uro – Oncology by SUI (Society Urology Internationale
Slide15REGISTRATION AT RGCIRC
Medical Records Department – 1996
Total Registration- 226012
Slide16AGE WISE DISTRIBUTION OF ALL CANCERS 1996-2017
Total Registration- 226012
Slide17MAGNITUDE OF CANCER BY GENDER
Slide18LEADING SITES OF CANCER – MALE (1996-2017)
Slide19LEADING SITES OF CANCER –FEMALE (1996-2017)
Represents Data of RGCIRC not India
Slide20MULTIPLE PRIMARY MALIGNANCY
Primary malignant tumors of different histological origins in an individual is defined as Multiple Primary Malignancy.
An increase in trend of people with multiple primary malignancies as a result of :
Improved diagnostics techniques & treatment modalities
Prolonged Life span
Enhanced survival of patients with malignancy
Slide21MULTIPLE PRIMARY MALIGNANCY
Previous studies indicate the incidence of multiple primary cancers to be between 0.734% and 11.7%.
Slide22OBJECTIVE & METHDOLOGY
To analyze the demographic, clinical and survival profile of patients with dual primary malignancies.
Slide23Total no. of malignant cases over a period of five years (2012-2016)
41,000 Total no. of patients with dual primary malignancy, n=216
Slide24Gender-wise Distribution
Slide25Most
Common First Primary Malignancy
Most
Common Second Primary Malignancy
Slide26Distribution on the Basis of Age Group
Slide27Distribution on the
Basis of Time Interval of O
ccurrence
Slide28Site of first primary malignancy
Male
Female
Total
Head & Neck
61
7
68
Breast
2
46
48Lung
2
1
3
Genitourinary
26
32
58
Gastrointestinal
20
11
31
Leukemia/ Lymphoma
4
2
6
Bone
2
0
2
Brain
0
0
0
Total
117
99
216
p-value <0.001
Site of first primary
malignancy
-
Results
Slide29Site of second primary malignancy
Male
Female
Total
Head & Neck
38
14
52
Breast
0
13
13
Lung
15
5
20
Genitourinary
24
48
72
Gastrointestinal
32
12
44
Leukemia/ Lymphoma
6
5
11
Bone
1
2
3
Brain
1
0
1
Total
117
99
216
p-value <0.001
Results
Slide30Male
Site of First Primary Malignancy
Site of Second Primary Malignancy
Slide31Female
Site of First Primary Malignancy
Site of
Second Primary
Malignancy
Slide32Characteristics
Age at first primary malignancy (years)
Age at second primary malignancy (years
)
Overall survival (months)
Duration between diagnosis of first and second primary malignancies
Mean
+
std
dev
54.6+11.6
58.8+11.3
75.1
+
87.6
52.4
+
79.7
Median
(Range
)
55
(23-88)
59
(25-89)
47
(0-502)
19
(0-501
)
Slide33SURVIVAL PROFILE
Alive: 32 (14.8 %)Dead :78 (36.1%)Lost to follow-up: 106 (49.1%)
Slide34Early detection and treatment is the key to better management of patients with double primary malignancies.
In a developing country like India, regular screening and follow up visits may help in the early detection of both synchronous and metachronous double primary malignancies.
CONCLUSION
Slide35REFERENCES
Dhillon, Preet K., et al. "The burden of cancers and their variations across the states of India: the Global Burden of Disease Study 1990–2016." The Lancet Oncology 19.10 (2018): 1289-1306.
Vogt, Alexia, et al. "Multiple primary tumours: challenges and approaches, a review." ESMO open 2.2 (2017): e000172.
Dandona
, L., et al. "India State-Level Disease Burden Initiative Collaborators. Nations within a nation: variations in epidemiological transition across the states of India, 1990–2016 in the Global Burden of Disease Study."
Lancet
390.10111 (2017): 2437-60.
Sullivan, Richard, et al. "Cancer research in India: national priorities, global results." The Lancet Oncology 15.6 (2014): e213-e222.www.who.int/news-room/fact-sheets/detail/cancer
(2) GBD 2015 Risk Factors Collaborators. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016 Oct; 388 (10053):1659-1724.(3)
Plummer M, de Martel C, Vignat J, Ferlay J, Bray F, Franceschi S. Global burden of cancers attributable to infections in 2012: a synthetic analysis. Lancet Glob Health. 2016 Sep;4(9):e609-16. doi: 10.1016/S2214-109X(16)30143-7
.https://www.indiatoday.in/education-today/gk-current-affairs/story/cancer-rate-india-stats-cure-treatment-1386739-2018-11-12
Dual malignancies: Do they have a worse prognosis than their individual counterparts TVA Chowdary, SM Sivaraj, GV Rao, S
ThirunavukkarasuDepartment of Surgical Gastroenterology, Narayana Medical College, Chintareddipalem, Nellore, Andhra Pradesh, India
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